Individual
ADAM G KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-0236
(352) 273-5550
Mailing address
PO BOX 100236, GAINESVILLE, FL 32610-0236
(352) 273-5550
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
237964
NY
2084N0400X
Neurology Physician
Primary
ME135304
FL
2084V0102X
Vascular Neurology Physician
237964
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024217500
—
FL
01
—
2084N0400X
TAXONOMY
—
01
—
RB4835
MEDICARE PTAN
NY
Enumeration date
08/14/2006
Last updated
07/05/2023
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